How to choose a fertility clinic: A concise guide

After months or even years of trying to start a family with no success, you may decide it’s time to consider fertility treatments.

Fertility clinics can help couples conceive, but when you start looking into your options, you may realize that finding the best IVF clinic is not that simple, especially considering the emotional and financial stakes at play.

In this guide, we’ll show you how to choose a fertility clinic by evaluating all the important factors, including costs, success rates, and staff expertise.

What do fertility clinics do, and when should you consider them?

Fertility clinics offer a wide range of services, including initial fertility assessment, diagnostic testing, and assisted reproductive technology (ART).

Once a diagnosis is made, based on your specific medical situation and personal goals, your fertility team will discuss the available treatment options. They may recommend different approaches, from lifestyle changes to ovulation-stimulating medication and procedures that address structural issues.

Good fertility clinics should also offer guidance, compassion, and space to ask questions and express concerns before and after treatment.

Bonus reads: Planning to undergo IVF? Learn about the different embryo testing options available:

• PGT-A

• PGT-M

• PGT-SR

• PGT-P

Source: Leah Newhouse

When should you consider a fertility clinic?

Many couples have been through initial testing with an OB-GYN and a urologist. Those tests can include bloodwork, hormone levels, ultrasound, or semen analysis, but also some procedures, such as hysterosalpingogram (HSG) and sonohysterography to examine the uterus and fallopian tubes.

For some couples, these basic tests don’t provide clear answers, and a fertility clinic may be the right next step.

According to RESOLVE, the national infertility association, you should consider seeing a fertility specialist if:

• You are under 35 and have difficulty conceiving for 12 months

• You are over 35 and have difficulty conceiving for 6 months

• You have had more than one miscarriage

• Your partner has poor semen as per relevant medical tests 

What are potential reasons for fertility issues?

Reasons why you may be struggling with fertility are diverse, from reproductive health to chronic medical conditions.

Below are some common reproductive issues that may require medical help:

Chronic medical conditions, even those unrelated to the reproductive system, can influence your ability to conceive or carry a healthy pregnancy, namely:

• Diabetes: Abnormal blood sugar can disrupt hormones, ovulation, and sperm quality, as well as increase pregnancy risk.

• High blood pressure: Hypertension can also cause pregnancy complications and affect reproductive organs.

• Thyroid disorders: Hyperthyroidism and hypothyroidism can interfere with menstrual cycles, egg release, and sperm function.

• Kidney disease: This condition can cause hormonal imbalances and make it more challenging to conceive and sustain pregnancy.

• Genetic conditions: Different inherited conditions, such as mutations in the cystic fibrosis gene and hereditary thrombophilias, can make it harder to conceive, increase miscarriage risk, and impact embryo health and, consequently, your future child.

💡Pro tip

Since genetic conditions can affect everything from embryo quality to your child’s long-term health, it’s worth considering genetic testing even before your first clinic appointment. Getting screened as a couple through genetic testing platforms like Nucleus may help avoid preventable heartache.

Unlike most commercial tests that scan less than 1% of your DNA, Nucleus uses clinical-grade whole-genome sequencing to analyze nearly 100% of your genetic code. You can complete the test at home, receive clear, actionable results, and understand your shared risks of passing on genetic conditions to your children long before you start fertility treatment.

Order the Nucleus DNA kit today and start planning your family with clarity and confidence.

Bonus reads: Learn why understanding your genetics is important for your future family:

• What is carrier screening?

• Benefits of carrier screening before and during IVF

How to choose an IVF clinic: 8 key factors to consider

According to the CDC, in 2021 alone, over 413,000 assisted reproductive technology (ART) cycles were performed across more than 450 clinics in the U.S., resulting in nearly 92,000 live births. Only two years before, these numbers were lower, with 330,773 ART cycles reported by 448 clinics and almost 78,000 live births.

Today, about 2.3% of all babies born in the U.S. are conceived using ART, with IVF being the most popular option.

Despite this progress, reproductive medicine is only partially regulated in the U.S. That’s why it’s crucial to do your research and choose a fertility clinic carefully.

Sections below examine eight critical factors to consider when deciding which fertility clinic to choose:

1. Providers’ expertise and credentials

One of the most important factors in choosing a fertility clinic is the expertise of the medical team.

Your healthcare provider should be a board-certified reproductive endocrinologist (REI), not a general OB-GYN or someone vaguely labeled a “fertility specialist.”

This is important because REIs undergo extensive training:

1. Four years of medical school

2. Four years of residency in obstetrics and gynecology

3. Three additional years of fellowship training in reproductive endocrinology and infertility

Once they have completed training, they must pass comprehensive written and oral exams to become board-certified in this field.

A well-trained provider is more likely to stay current in reproductive medicine and tailor treatment plans to your particular needs.

2. Fertility clinic’s success rates

In the U.S., there are two reliable sources for fertility clinic success rates:

1. Centers for Disease Control and Prevention (CDC)

2. Society for Assisted Reproductive Technology (SART)

Patients find SART more useful because the database is updated annually and provides more detailed, clinic-level information.

[Reddit](https://www.reddit.com/r/InfertilitySucks/comments/11zmx0h/comment/jddgdrj/)(315)

To get the most relevant information, focus on live birth rates and the number of cycles for your age group.

Source: RDNE stock project

It’s also worth checking the clinic’s donor egg success rates. Since donor eggs usually come from young, healthy individuals, they represent the ideal conditions for IVF success. If a clinic consistently has high success rates, it likely has:

• High-quality lab practices

• Skilled embryologists

• Strong protocols

Still, don’t take statistics at face value because some clinics may be cherry-picking patients, declining older patients unless they agree to use donor eggs. This artificially inflates success rates and raises ethical questions regarding access to care.

Other clinics may specialize in helping older patients or those with diminished ovarian reserve, which can lower their success rates but reflect a commitment to inclusivity.

If the success rates seem low, ask why. A good IVF clinic will be transparent and able to explain its numbers.

You should also inquire about the lab and ask questions such as:

• What are the fertilization rates?

• How many embryos make it to the blastocyst stage?

• What percentage of embryos survive thawing?

The table below shows some reference percentages:

3. IVF case volume

The number of IVF procedures performed each year can offer valuable insights into a clinic’s experience.

While there is no strict benchmark, clinics that perform under 100 IVF procedures a year are considered low volume and possibly less equipped to handle cases at a scale.

As a baseline, clinics must perform at least 20 egg retrievals or embryo transfers a year to become members of SART. Remember that while larger practices may offer state-of-the-art labs and expensive resources, smaller clinics might provide more personalized care and consistent communication.

4. IVF clinic’s medical philosophy and treatment approach

IVF clinics and physicians differ in medical philosophy. Some clinics have a more standardized, protocol-driven approach, while others tailor the care to patients’ medical history.

For instance, you should check if a clinic performs procedures every day of the week, including weekends, in case your cycle requires it.

Some clinics close on weekends, which may cause delays, suboptimal scheduling, or even cancelled cycles. You need a clinic that can adapt to your body’s timing, not vice versa.

Similarly, some clinics use birth control pills or other methods to synchronize patient cycles for convenience or lab scheduling. This may be appropriate in some cases, but it’s not ideal for all patients.

It is also crucial to understand how the clinic handles complex situations, and what it will do if a patient:

• Has an autoimmune disease

• Has been through several pregnancy losses

• Has been through multiple failed IVF attempts

The goal is to see whether the clinic can provide the service you need, rather than apply the same one-size-fits-all approach.

Finally, ask about the clinic’s stance on preimplantation genetic testing (PGT) and mosaic embryos. Will they consider them for transfer, or are they routinely discarded as abnormal?

This is crucial information, especially since many patients have had successful pregnancies and healthy babies after transferring a mosaic embryo:

[Reddit](https://www.reddit.com/r/InfertilityBabies/comments/rc04jz/comment/hnrou5x/)(540)

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5. Services and support provided

IVF offers the highest success rates, but it’s also the most invasive and expensive treatment. Most importantly, not everyone needs IVF right away — or at all.

The best fertility clinic for you will meet you where you are, offering various fertility treatment options and building a plan that fits your needs.

Your IVF clinic should offer treatments such as:

• Ovulation induction

• Timed intercourse cycles

• Intrauterine insemination (IUI)

• IVF with or without ICSI

• Egg or sperm donation

• Fertility preservation (egg, sperm, or embryo freezing)

• Genetic testing (PGT)

• Complementary services, such as counseling and mental health resources

Fertility care isn’t only about different procedures; it’s also about feeling supported and heard. From the first interaction, pay attention to how the staff operates, communicates, and makes you feel.

Your calls and messages should be returned in a timely and respectful manner, the staff members should be kind and helpful, and you should never feel rushed or overlooked.

Source: Cottonbro studio

You should know who you will be seeing throughout the treatment, whether you will be working with one doctor primarily or rotating between several providers. Neither is wrong, but you should have this information so you can feel confident and comfortable with the level of consistency and access the clinic can provide.

6. The cost of fertility treatment

Fertility treatment is a significant financial investment. In the U.S., a single IVF cycle can cost between $15.000 and $30,000, and most people need more than one cycle to conceive. On average, it takes about 2.5 IVF cycles. Other options, such as IUI and ovulation induction, cost less, but also require multiple rounds.

Some states have laws requiring insurance plans to cover fertility treatment, but coverage varies widely. If you have an insurance plan, confirm whether it includes fertility benefits and if the clinic and doctors you are considering are in-network.

Even if your coverage doesn’t include fertility treatment specifically, some clinics may use alternative diagnostic codes, such as ovulation disorder or suspected endometriosis, which can help you get at least partial coverage.

Sometimes, even if a clinic doesn’t accept insurance, it may still offer reasonable financing options or payment plans to make treatment more accessible.

Ask the clinic for a complete breakdown of the costs, including medication, procedures, lab fees, and consultations, and make sure there are no hidden fees.

7. Location of the IVF clinic

Location matters more than you may think when it comes to choosing the best fertility clinic.

Fertility treatments often require frequent, time-sensitive appointments, which can span weeks or even months. Many appointments are scheduled on short notice based on test results or cycle timing.

Opting for a clinic reasonably close to home can reduce physical, emotional, and logistical stress. Larger practices often have multiple locations, and some clinics partner with local labs to facilitate morning monitoring.

8. Patient reviews

Patient satisfaction can offer something that data can’t — insight into what it feels like to be treated at a particular clinic.

[Reddit](https://www.reddit.com/r/InfertilitySucks/comments/11zmx0h/comment/jdepqmk/)(265)

Reviews can fill in the gaps regarding what to expect, both from a medical standpoint and a human one. They can help you decide whether a clinic you are considering fits your personal preferences and priorities.

Still, not all reviews are equally useful. Don’t focus on a single glowing or angry review; instead, look for patterns across multiple posts. For instance, see whether the patients constantly praise the communication or complain about billing issues and waiting times.

Here is where you can search or ask for patient experiences:

• FertilityIQ: Reviewers usually share detailed and clinic-specific information.

• Yelp and Google reviews: They typically offer insights into front desk service or appointment waiting times.

• Reddit and fertility-focused Facebook groups: You can find unfiltered feedback from real patients and benefit from real-time discussions.

What comes after you decide which fertility clinic to choose?

Once you have chosen the right fertility clinic, you may feel like you have finally reached solid ground, but the journey is not over yet. The next steps become even more personal.

Many clinics offer the option of PGT to identify viable embryos. Once the testing is done, you may find yourself with several healthy embryos and a new dilemma — which embryo to transfer?

PGT helps identify embryos most likely to result in a healthy pregnancy, but it offers no insight into their long-term health potential, and many severe genetic disorders can fly under the radar.

Ask your doctor about preimplantation genetic testing for polygenic disorders (PGT-P) to get a more complete picture of your embryos' health.

PGT-P can offer a much deeper assessment of your embryos’ long-term health, including risks for common adult-onset diseases like Type 1 and Type 2 diabetes, coronary artery disease, ADHD, and depression. And once you have your PGT-P results in hand, consider adding Nucleus Embryo to your fertility journey to help you understand embryo health outcomes better.

Make the most informed choice with Nucleus Embryo

Nucleus Embryo is an advanced embryo analysis platform that gives you deep insights into each embryo’s potential. Using clinical-grade whole-genome sequencing, Nucleus analyzes up to 20 embryos, showing you each embryo’s:

• Health risks for multiple hereditary conditions

• Well-being and health indicators, including genetic markers for mental health

All results are presented in a clear, easy-to-understand format in an interactive dashboard that allows you to analyze embryos at your own pace. Couples can sort, compare, and even name their embryos before selecting one for implantation.

If you need more guidance, you can consult licensed genetic counselors through Nucleus partners.

How to get started with Nucleus Embryo

You can get started with Nucleus Embryo during or after your IVF cycle. Here is what to do:

1. Ask your fertility clinic about PGT-P testing with LifeView by Genomic Prediction

2. Sign up for Nucleus Embryo before or after your IVF cycle

3. Get your embryos’ PGT-P results from your clinic

4. Upload the data to Nucleus Embryo and get a complete embryo health analysis

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Featured image source: Marta Branco